Wellspring of Life Enterprises LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLSPRING OF LIFE ENTERPRISES LLC

Practice address

109 W Bland St
Roswell, NM 88203-5708

Phone

(575) 420-1609

NPI assigned

Jul 30, 2020

Last updated

Jul 30, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mary McMahon

Title

Owner

Phone

(575) 420-1609

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott W McMahon, MD

  • Pediatrics Physician
  • Roswell, NM
  • NPI 1528078938
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1700495165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882020711",
            "telephone_number": "575-420-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W BLAND ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882035708",
            "telephone_number": "575-420-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING OF LIFE ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-420-1609",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Watkins
• Wayne a Delamater MD PA
• Wellcare Inc of Roswell (WellCare Home Health)
• Wellcare, Inc. (Enhabit Home Health)
• Wellness on Wheels LLC (Wellness on Wheels)
• Donald E Wenner III, M.D.
• Donald E. Wenner, M.D.
• West Road Emergency Physicians
• West Texas Rehabilitation Services, LLC (RehabGenix)
• Staci Michelle West, ACNP DNP

• Family Medicine Physician in Roswell, NM
• Providers in Roswell, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.